Amitriptyline

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While its effects vary with individuals, it tends to be relatively more sedating and have more anticholinergic side effects than other tricyclics. Its sedating property may be exploited in the treatment of insomnia.

Depression

When prescribed for depression, it may take three weeks or more to be effective, and the dose may have to be raised slowly to manage side effects. For depression, the typical daily dose is 75-300 mg.

Pain management

In the treatment of chronic pain smaller doses can be used then when treating depression. Amitriptyline usually acts more quickly.

Chronic pain syndromes

Neurogenic pain

In a randomized controlled trial of patients with diabetic neuropathy, amitriptyline was better than fluoxetine[1] In this trial, amitriptyline was effective in patients regardless of whether they had depression, whereas fluoxetine was effective only in depressed patients.

In a randomized crossover trial of patients with diabetic neuropathy, amitriptyline provided moderate or greater pain relief in 67% of patients as compared to 52% with gabapentin. In this small study, this result was statistically insignificant.[2]